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恶性腹水的研究进展与治疗现状

Research progress and treatment status of malignant ascites.

作者信息

He Jing, Zhang Hui-Ping

机构信息

Department of Traditional Chinese Medicine, The First Affiliated Hospital of Dali University, Dali, China.

Department of Oncology, Guang'anmen Hospital Jinan Hospital (Jinan Hospital of Traditional Chinese Medicine), Jinan, China.

出版信息

Front Oncol. 2024 Dec 16;14:1390426. doi: 10.3389/fonc.2024.1390426. eCollection 2024.

Abstract

Malignant ascites (MA), a common and serious complication of various cancers in the abdominal cavity, originates from the extensive infiltration, metastasis, and growth of cancer cells in or on the abdominal cavity, leading to abnormal accumulation of fluid in the abdominal cavity and the formation of MA. MA seriously reduces the quality of life of cancer patients, shortens their survival period, and generally has a poor prognosis. Modern medicine has developed various strategies for the treatment of MA, including targeted supportive treatment, diuretic treatment, abdominal paracentesis, surgical intervention, and intraperitoneal administration therapy. Among them, chemotherapy, as one of the important treatment methods, includes both systemic chemotherapy and intraperitoneal chemotherapy, especially pressurized intraperitoneal aerosol chemotherapy (PIPAC), hyperthermic intraperitoneal chemotherapy (HIPEC), and foam-based intraperitoneal chemotherapy (FBIC), providing a new choice for the treatment of MA. In addition, innovative treatment methods such as gas-based intra-abdominal hyperthermia (GIH) combined with dehydration therapy have also shown promising application prospects. This article delves into multiple aspects of MA, including its concept, mechanism of occurrence, clinical manifestations, differential diagnostic methods, and current treatment status and research progress. This comprehensive review aims to provide valuable references for effectively controlling MA, improving cancer patients' quality of life, and prolonging the survival cycle of cancer patients in clinical practice. Malignant ascites (MA) is a common complication of cancer, which originates from the extensive infiltration, metastasis, and growth of cancer cells in the abdominal cavity or peritoneum, leading to abnormal accumulation of peritoneal fluid. It is a common clinical manifestation in the late stage of cancer. Its symptoms are stubborn and recurrent, which can lead to abdominal pain, bloating, poor appetite, fatigue, breathing difficulties, and even multiple organ failure. The median survival time for cancer patients with MA is generally 5 to 6 months. The prognosis is poor, and it is imperative to seek more active and effective treatment plans. This article reviews the research and treatment status of MA, aiming to provide certain value for controlling MA and improving the quality of life of patients.

摘要

恶性腹水(MA)是腹腔内各种癌症常见且严重的并发症,它源于癌细胞在腹腔内或腹腔上的广泛浸润、转移和生长,导致腹腔内液体异常积聚并形成恶性腹水。恶性腹水严重降低癌症患者的生活质量,缩短其生存期,总体预后较差。现代医学已开发出多种治疗恶性腹水的策略,包括靶向支持治疗、利尿治疗、腹腔穿刺放液、手术干预及腹腔内给药治疗。其中,化疗作为重要的治疗方法之一,包括全身化疗和腹腔内化疗,尤其是加压腹腔内气溶胶化疗(PIPAC)、热灌注腹腔内化疗(HIPEC)和泡沫型腹腔内化疗(FBIC),为恶性腹水的治疗提供了新选择。此外,气基腹腔内热疗(GIH)联合脱水疗法等创新治疗方法也显示出良好的应用前景。本文深入探讨了恶性腹水的多个方面,包括其概念、发生机制、临床表现、鉴别诊断方法以及当前的治疗现状和研究进展。这篇综述旨在为临床实践中有效控制恶性腹水、提高癌症患者生活质量和延长癌症患者生存周期提供有价值的参考。恶性腹水(MA)是癌症的常见并发症,它源于癌细胞在腹腔或腹膜的广泛浸润、转移和生长,导致腹腔积液异常积聚。它是癌症晚期常见的临床表现。其症状顽固且反复发作,可导致腹痛、腹胀、食欲不振、疲劳、呼吸困难,甚至多器官功能衰竭。患有恶性腹水的癌症患者的中位生存时间一般为5至6个月。预后较差,寻求更积极有效的治疗方案势在必行。本文综述了恶性腹水的研究和治疗现状,旨在为控制恶性腹水和提高患者生活质量提供一定价值。

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